title: Misdiagnosis of cutaneous leishmaniasis and recurrence after surgical excision.
abstract: Cutaneous Leishmaniasis (CL) occurs in British troops deployed to Belize, Afghanistan, Iraq and elsewhere. From 1998 to 2009, 156 (45%) of 343 confirmed cases seen in the UK were in military personnel. CL is a rare disease and requires specialist clinical management because numerous pitfalls exist during diagnosis and treatment. A 19-year-old soldier developed CL on his neck 6 weeks after taking part in jungle warfare training in Belize. However, this was not suspected and the diagnosis was not made from either a skin biopsy or following surgical excision. The travel history and the patient's own photograph prompted retrospective investigations that confirmed this was CL due to Leishmania mexicana. Three months after surgery, the disease recurred locally and was treated appropriately with a good outcome. British military personnel with suspected CL should be referred to the UK Role 4 Military Infectious Diseases & Tropical Medicine Service.
authors.affiliation: Department of Infection & Tropical Medicine, Birmingham Heartlands Hospital, Birmingham, UK Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Bailey
authors.affiliation: Department of Histopathology, Birmingham Heartlands Hospital, Birmingham, UK.
authors.forename: G
authors.initials: G
authors.lastname: Langman
mesh_terms: D000328:Adult; D000967:Antimony Sodium Gluconate / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001531:Belize; D001706:Biopsy; D003951:Diagnostic Errors; D006801:Humans; D016773:Leishmaniasis, Cutaneous; D008297:Male; D008889:Military Personnel; D006113:United Kingdom; D055815:Young Adult
chemical_list: D000981:Antiprotozoal Agents; D000967:Antimony Sodium Gluconate
keywords: Belize; Leishmaniasis, Cutaneous; Military Personnel; Skin Diseases, Infectious